Provider Demographics
NPI:1538572060
Name:ARNOLD, TERESITA (COTA)
Entity type:Individual
Prefix:MRS
First Name:TERESITA
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 N WESTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-1052
Mailing Address - Country:US
Mailing Address - Phone:316-943-0020
Mailing Address - Fax:
Practice Address - Street 1:3636 N RIDGE RD STE 400
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1221
Practice Address - Country:US
Practice Address - Phone:316-977-8892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-00874224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant